Colorado Department of Transportation

COLORADO DEPARTMENT OF TRANSPORTATION PROPRIETARY ITEM – CERTIFICATIONS OR FINDING IN THE PUBLIC INTEREST (FIPI)

INSTRUCTIONS; A specific patented or proprietary material, specification, or process shall not be required on a contract except as permitted in Section 2.24 of the Project Development Manual (PDM). Use this form to obtain approval of the use of a proprietary feature on a project or group of projects. PROPRIETARY ITEM OR PROCESS: Name of proprietary item or process: Manufacturer name, address & phone No.:

NEED FOR PROPRIETARY ITEM: Check only one LOCATION Project Specific (if FHWA has Provide Project No., Project Code, and Location: no interest then RE approval otherwise requires FHWA approval) – FIPI or (Stds & Specs Engr approves) - Certification Corridor Specific (if FHWA has Provide Corridor Description: no interest then RE approval otherwise requires FHWA approval) – FIPI or (Stds & Specs Engr approves) - Certification Region-wide(Progrm Engr Identify CDOT Region: approval and requires FHWA approval) – FIPI or (Stds & Specs Engr approves) - Certification Statewide(Branch Mgr approval and requires FHWA approval) – FIPI or (Stds & Specs Engr approves) - Certification

For a corridor, region-wide, or statewide request, a Certification or FIPI will have a term of: (Check only one) 3 Years Specify dates of term: (maximum allowable)

Other (specify term) Specify dates of term:

of 2 CDOT FORM 1381 09/14 JUSTIFICATION I hereby certify that it is in the public interest to specify the above named proprietary item or process for the following reasons: (Check all that apply) It is essential for synchronization.(Certification only)

No equally suitable alternative exists.(Certification only) It will be used for research or experimental purposes on short sections of road. (Such use must be processed through the Research Branch of DTD. Attach documentation from DTD.) (FIPI only)

It is in the public interest not to allow any other products even though other equally acceptable materials or products are available. (FIPI only) JUSTIFICATION (required). Justification consists of information that documents the reasons marked above for use of the proprietary item or process. For research or experimentation include a work plan that describes how the research or experimental feature will be used and evaluated. Attach additional pages and documentation as necessary.

APPLICANT SIGNATURE Name Title (CDOT Resident Engineer, Program Signature Date Engineer, or Branch Manager, as appropriate; see flowchart in section 2.24 of the PDM):

APPROVAL SIGNATURES: Signature CDOT Resident Engineer Date (Required on project specific or corridor FIPIs) Signature CDOT Research Engineer Date (Required for research and experimentation FIPIs) Signature FHWA Operations Engineer Date (Required for all region-wide and statewide FIPIs and FHWA oversight project level FIPIs) Signature CDOT Stds.&Specs. Engr. Date (Required for all proj.specific, corridor, region-wide &statewide Certifications) COPIES OF APPROVED FORM TO (as appropriate): CDOT Project Engineer CDOT Resident Engineer:

CDOT Program Engineer: CDOT Research Engineer:

CDOT Standards and Specifications Engineer (all, FIPI with draft of any CDOT Branch Manager required specification change):

FHWA Operations Engineer:

of 2 CDOT FORM 1381 09/14